Mania

The primary symptom of a manic episode is a marked disturbance of mood in which the individual is extremely elated or irritable for at least one week unless hospitalization is necessary. The individual's mood may be unusually cheerful or good, and while this may not seem unusual to those who do not know the individual, to those who do, it is usually seen as excessive and strange. The person's mood may also be one of extreme irritability, especially when his or her desires and goals are interfered with. It also quite common for the person to switch rapidly between irritability and elation. In addition to the mood disturbance the individual will usually show three or four of the following symptoms.

In a manic episode the need for less sleep is almost always seen, so that the individual may rise hours earlier than normal yet still be full of energy. Indeed, the person may not sleep for days but feel no fatigue. Another common symptom is overly high self-confidence. The individual may attempt complex and difficult tasks for which he or she has no experience or knowledge, such as sailing around the world or climbing Mount Everest. The person may also have grandiose delusions (false beliefs that do not seem possible) about himself or herself. Rapid and loud speech that is difficult to interrupt is also a common symptom. Speech will often show a pressured quality as if the person is compelled to speak, so that an individual may talk a lot, sometimes for hours without stopping. Extremely rapid or racing thoughts are often present in a manic episode. This may be seen in very rapid speech in which the individual switches topics very rapidly, and in extreme cases speech may become so disorganized that it is incomprehensible. A person having a manic episode will often plan and participate in an excessive amount of goal-directed behaviors, such as sexual, professional, political, or religious activities. The individual may, for example, volunteer in numerous school or work related committees without regard to whether they can fulfill these obligations. Often a person having a manic episode does not believe there is anything wrong, and resists treatment. Taken together, these symptoms often lead to reckless behaviors the individual would not normally engage in that are likely to have negative consequences. For instance, the individual may make unnecessary purchases that he or she cannot afford, or make unwise investments. In order for a diagnosis of manic episode to be made, an individual's interpersonal, professional, or school functioning must be noticeably impaired or hospitalization must be required because of these symptoms.